scholarly journals The Role of Ferritin in Assessing COVID-19 Severity

2021 ◽  
Vol 18 (4) ◽  
pp. 20-28
Author(s):  
Yu. S. Polushin ◽  
I. V. Shlyk ◽  
E. G. Gavrilova ◽  
E. V. Parshin ◽  
A. M. Ginzburg
Keyword(s):  
Blood Level ◽  
Iron Metabolism ◽  
Ferritin Level ◽  
Unfavorable Outcome ◽  
Disease Outcome ◽  
Blood Levels ◽  
Indirect Bilirubin ◽  
Outcome Group ◽  
The Difference ◽  
Complement C5a

Ferritin is one of the biomarkers requiring special attention; its blood level increases significantly especially in the severe course of COVID-19. Information on the effect of hyperferritinemia on the disease outcome is very contradictory as are the ideas about the causes of its development.The objective: to study the effect of hyperferritinemia on the disease outcome and analyse the possible causes of its development in severe COVID-19.Subjects and Methods. Data on 479 patients with severe course of coronavirus infection treated in intensive care units (ICU) were retrospectively analyzed. Of them, the proportion of patients with a favorable outcome (Group 1) was 51.0% (n = 241), and with an unfavorable outcome (Group 2) - 49.0% (n = 235). The following parameters were assessed: the levels of ferritin, C-reactive protein, fibrinogen, IL-6, IL-10, IL-18, procalcitonin, complement C5a, total, direct and indirect bilirubin, ALT, AST, and the blood level of lactate dehydrogenase (LDH). The changes of erythrocyte count and hemoglobin blood level were also monitored. In order to form a clear view of iron metabolism, free iron, transferrin, and myoglobin levels were assessed in several patients with high ferritin values (more than 1,500 pg/L).Results. In the unfavorable outcome, ferritin levels increase very significantly, reaching maximum by day 6 of patients' stay in ICU. The difference in the level of ferritin between the groups of survivors and deceased during this period is clear and significant (p = 0.0013). The association of ferritin values with the outcome is detected as early as day 1, but by day 4 it becomes highly significant (the cut-off point is 1,080 pg/l). No data have been obtained that would indicate the association of hyperferritinemia with impaired iron metabolism, the development of hepatic dysfunction, or cellular destruction. In contrast to survivors, those who died on day 6 had elevated IL-6 while C5a level remained unchanged. Conclusions. The rapid increase in ferritin blood levels to 1,000 pg/L or higher is an unfavorable prognostic sign indicating a high probability of a lethal outcome. When assessing genesis of hyperferritinemia in COVID-19, the crucial significance should be attributed to the cytokine storm rather than disorders of iron metabolism or hemotoxic effects of the virus. The persistent increase of ferritin level in blood during 4-6 days of stay in ICU should be considered as a reason to intensify anticytokine therapy.

scholarly journals The Blood level of Thioredoxin 1 as a Supporting Biomarker in the Detection of Breast Cancer

2021 ◽  
Author(s):  
Youn Ju Lee ◽  
Young Kim ◽  
Bo Bae Choi ◽  
Je Ryong Kim ◽  
Hye Mi Ko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Level ◽  
Histological Grade ◽  
Unmet Need ◽  
Blood Levels ◽  
Test Results ◽  
Long Time ◽  
Thioredoxin 1 ◽  
The Difference ◽  
Diagnostic Modalities

Abstract Background: It has been a long-time unmet need to have a means to detect breast cancer (BC) using blood. Although mammography is accepted as the gold standard for screening, thus, playing a role to reduce death from breast cancer, a blood-based diagnostic can complement mammography and assist in the accurate diagnosis of BC. We have previously reported the possible use of thioredoxin 1 (Trx1) in serum as a novel means to detect BC. In the present study, we validated the clinical utility of Trx1 to detect BC by testing sera from biopsy-confirmed cancer patients, and normal healthy people.Methods: We have generated monoclonal antibodies against Trx1 and developed an ELISA kit that can quantitate Trx1 in sera. The level of Trx1 was determined in each serum from normal healthy women (n=114), as well as patients with BC (n=106), and other types of cancers (n=74) including cervical, lung, stomach, colorectal, and thyroid cancer. The sera from BC patients were collected according to their age and cancer stage. Several pathological and molecular aspects of BC were analyzed along with the Trx1 levels of BC patients. Test results were compared to those from mammography. Each test was duplicated, and test results were analyzed by ROC analysis, one-way ANOVA tests, and unpaired t-tests.Results: The mean level of Trx1 from normal women’s sera was 5.45±4.16 (±SD) U/ml and that from BC was 21.96±6.79 U/ml. The difference between these two values was large enough to distinguish BC sera from healthy sera with a sensitivity of 94.3% and specificity of 94.7% (AUC 0.985, p<0.0001). Most Trx1 levels from BC patients’ sera were higher than the cut-off value of 14.13 Unit/ml regardless of age, stage, histological grade, type, and specific receptors’ expression profile of BC. The blood levels of Trx1 from the group of patients with other types of cancers (2.70±2.01 U/ml) was low to be distinguishable from BC. Trx1 level could rescue most of misreading incompleteness of mammography. Conclusion: These results indicated that the blood level of Trx1 could be an effective and accurate means to assist or complement current BC diagnostic modalities.

scholarly journals Intracranial Pressure during External Ventricular Drainage Weaning Is an Outcome Predictor of Traumatic Brain Injury

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jia-cheng Gu ◽  
Hong Wu ◽  
Xing-zhao Chen ◽  
Jun-feng Feng ◽  
Guo-yi Gao ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
External Ventricular Drainage ◽  
Unfavorable Outcome ◽  
Ventricular Drainage ◽  
Outcome Group ◽  
Significant Difference ◽  
The Mean ◽  
The Relationship

External ventricular drainage (EVD) is widely used in patients with a traumatic brain injury (TBI). However, the EVD weaning trial protocol varies and insufficient studies focus on the intracranial pressure (ICP) during the weaning trial. We aimed to establish the relationship between ICP during an EVD weaning trial and the outcomes of TBI. We enrolled 37 patients with a TBI with an EVD from July 2018 to September 2019. Among them, 26 were allocated to the favorable outcome group and 11 to the unfavorable outcome group (death, post-traumatic hydrocephalus, persistent vegetative state, and severe disability). Groups were well matched for sex, pupil reactivity, admission Glasgow Coma Scale score, Marshall computed tomography score, modified Fisher score, intraventricular hemorrhage, EVD days, cerebrospinal fluid output before the weaning trial, and the complications. Before and during the weaning trial, we recorded the ICP at 1-hour intervals to calculate the mean ICP, delta ICP, and ICP burden, which was defined as the area under the ICP curve. There were significant between-group differences in the age, surgery types, and intensive care unit days (p=0.045, p=0.028, and p=0.004, respectively). During the weaning trial, 28 (75.7%) patients had an increased ICP. Although there was no significant difference in the mean ICP before and during the weaning trial, the delta ICP was higher in the unfavorable outcome group (p=0.001). Moreover, patients who experienced death and hydrocephalus had a higher ICP burden, which was above 20 mmHg (p=0.016). Receiver operating characteristic analyses demonstrated the predictive ability of these variables (area under the curve AUC=0.818 [p=0.002] for delta ICP and AUC=0.758 [p=0.038] for ICP burden>20 mmHg). ICP elevation is common during EVD weaning trials in patients with TBI. ICP-related parameters, including delta ICP and ICP burden, are significant outcome predictors. There is a need for larger prospective studies to further explore the relationship between ICP during EVD weaning trials and TBI outcomes.

Studies on the carbohydrate metabolism of sheep. XVI. Partition of ketone bodies in blood, tissues, and urine

1962 ◽  
Vol 13 (2) ◽  
pp. 307 ◽  
Author(s):  
RL Reid
Keyword(s):  
Renal Clearance ◽  
Blood Level ◽  
Ketone Bodies ◽  
Urine Flow ◽  
Blood Levels ◽  
Renal Tubules ◽  
Hydroxybutyric Acid ◽  
Acetoacetic Acid ◽  
Tissue Concentrations ◽  
Blood Concentrations

Acetone comprised 0–40% (average 18%) of the acetoacetic acid plus acetone fraction in sheep blood, in which the level of this fraction was 0.6–5.2 mg % (as acetone). Acetoacetic acid was largely converted to acetone during storage of blood at –20°C, with intermittent thawing for analysis. Concentrations of acetoacetic acid in red cells were similar to those in plasma, but those of ß-hydroxybutyric acid were considerably lower. In contrast to acetoacetic acid, ß-hydroxybutyric acid was virtually absent from foetal blood and from brain tissue. Concentrations of both ketone fractions in liver and muscle tissue were about one-half the blood concentrations. The renal clearance of acetoacetic acid plus acetone in hyperketonaemic pregnant ewes was independent of blood level up to 20 mg % and was little affected by rate of urine flow. Clearance values were in the range of 4–9 ml per min, which indicates that most of the acetoacetic acid filtered at the glomeruli is absorbed by the renal tubules. Renal clearance of ß-hydroxybutyric acid was dependent on blood level and was more affected by rate of urine flow than that of acetoacetic acid. Very little ß-hydroxybutyric acid appeared in the urine when blood levels were below 15 mg %. Clearance increased as blood concentration rose above this level, and reached maximum values, mostly of 3–5 ml per min, at blood levels exceeding 30 mg %.

scholarly journals Relationship between plasma concentrations of estradiol-17β and progesterone and the distribution of epithelial and inflammatory cells in the external opening of the river buffaloes’ uterine cervix during the gestational period

2021 ◽  
Vol 24 (3) ◽  
pp. 365-375
Author(s):  
M. Goli ◽  
E. Ayen ◽  
S. Hassanzadeh ◽  
M. H. Khadem Anssari
Keyword(s):  
Uterine Cervix ◽  
Jugular Vein ◽  
Plasma Concentrations ◽  
Inflammatory Cells ◽  
Gestation Period ◽  
Blood Levels ◽  
External Opening ◽  
Microscopic Evaluation ◽  
The Difference ◽  
Estradiol 17Β

Changes in the distribution of the epithelial and inflammatory cells in the external opening of the uterine cervix in river buffaloes at three different occasions during the gestation period were investigated by light microscopic evaluation of mucus smears prepared by wet swab sampling and Giemsa-stained. Forty five pregnant river buffaloes that were in the first (n=15), second (n=15) and third (n=15) approximately equal parts of their gestation period were sampled twice concurrently by individual wet swabs from the external opening of the uterine cervix. Five smears were prepared from each sample. Immediately after mucus sampling, blood samples were obtained from the jugular vein of each animal, centrifuged immediately and stored at -20 oC to assay the plasma levels of estradiol-17β and progesterone. The results showed that changes in the percentage of the vacuolated and non-vacuolated epithelial cells, lymphocytes, eosinophils, and basophils were not statistically significant between the groups, which suggests that as the pregnancy progressed, changes in the blood levels of estradiol-17β and progesterone had little or no effect on the distribution of these cells in the region, but changes in the percentage of neutrophils were statistically significant between the groups. It was also found that changes in the percentage of macrophages between the second and third trimesters of the gestation period were not significant, but the difference between the first and the other trimesters was statistically significant. It was concluded that the percentages of neutrophils and macrophages increase significantly as the plasma concentrations of progesterone decrease during the gestation.

Abstract 329: Six at Six: Interleukin-6 Measured at 6 Hours After Cardiac Arrest Is a Good Predictive Biomarker of Outcome of Post--Cardiac Arrest Syndrome in Humans

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Koichiro Shinozaki ◽  
Lance B Becker ◽  
Shigeto Oda ◽  
Hiroyuki Hirasawa
Keyword(s):  
Cardiac Arrest ◽  
Blood Level ◽  
Selection Procedure ◽  
Early Death ◽  
Patient Characteristics ◽  
Predictive Biomarker ◽  
Blood Levels ◽  
Multicenter Observational Study ◽  
Therapeutic Decision Making ◽  
Post Cardiac Arrest Syndrome

Introduction: As early as 3h after cardiac arrest (CA), the blood level of various cytokines increases and may be associated with outcome of post cardiac arrest syndrome (PCAS). However, it remains uncertain whether blood levels of these cytokines including IL-6 have significance as predictors of outcome following cardiac arrest. Objective: To demonstrate any association between circulating IL-6 level, one of major pro-inflammatory cytokines, and mortality in PCAS of humans. Methods: This was a multicenter observational study conducted between 2006-09 in Chiba, Japan, involving non-trauma CA adult patients. All patients admitted to acute care units were included. Patient characteristics were extracted following an Utstein template. The primary outcome was mortality through the end of the study. IL-6 blood levels were measured on admission, at 6hr, and 24hr after CA. Patients were classified into three groups (high, middle, and low) according to IL-6 levels at each time point. We evaluated the association of IL-6 levels with survival using the Kaplan-Meier method. A Cox proportional hazard model with a step-wise selection procedure was used to identify independent variables associated with overall survival. Results: A total of 227 patients were included in this study. Survival time in “High IL-6” group was shorter than “Low” group. There were significant differences in blood level of IL-6 in the three groups, high (>811pg/mL), mid (811-93pg/mL), and low (<93pg/mL), only at 6hr (long rank; high vs. low p<0.001, high vs. mid p=0.07, and mid vs. low p=0.001 on admission; p<0.001, p<0.001, and p<0.001 at 6hr, respectively; p<0.001, p<0.001, and p=0.936 at 24hr, respectively). Three factors were identified as independent predictors of early death; no bystander CPR (hazard ratio [95% confidential interval], 2.59 [1.10-6.10], p=0.03), a lack of therapeutic hypothermia (2.68 [1.70-4.22], p<0.001), and IL-6 levels at 6hr (high, reference; mid, 0.41 [0.25-0.66], p<0.001; low, 0.11 [0.06-0.20], p<0.001). Conclusions: IL-6 measured at 6hr can predict mortality. It should be studied further to see if it can help direct therapeutic decision-making and whether it can define optimal populations for study in clinical trials.

Rhombencephalitis in Children: Diffusion Magnetic Resonance Imaging (MRI) Correlation With Clinical Outcomes

2020 ◽  
Vol 35 (6) ◽  
pp. 404-409
Author(s):  
Alex Mun-Ching Wong ◽  
Chih-Hua Yeh ◽  
Jainn-Jim Lin ◽  
I-Jun Chou ◽  
Kuang-Lin Lin
Keyword(s):  
Clinical Outcomes ◽  
Diffusion Weighted Imaging ◽  
Multivariate Logistic Regression Analysis ◽  
Inversion Recovery ◽  
Unfavorable Outcome ◽  
Multivariate Logistic Regression ◽  
Diffusion Weighted ◽  
Disturbance Of Consciousness ◽  
Outcome Group ◽  
Fluid Attenuated Inversion Recovery

In children with rhombencephalitis, neuroimaging abnormalities have been infrequently correlated with clinical outcome. We investigated whether magnetic resonance (MR) neuroimaging studies could predict clinical outcomes and disturbance of consciousness in patients with rhombencephalitis. We retrospectively analyzed the MR studies of 19 pediatric patients with rhombencephalitis (median age: 4.2 years, range 0.5-17; sex: 32% male). Fluid-attenuated inversion recovery imaging and diffusion-weighted imaging findings were graded to create imaging scores according to the extent of imaging abnormality. Clinical outcomes in the first week and 12th month were graded by using Glasgow Outcome Scale scores (1-5) and dichotomized to unfavorable or favorable outcome. Correlations of the imaging scores with the clinical outcomes and with disturbance of consciousness were assessed by using multivariate logistic regression analysis. No significant correlation was found between fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .608, P = .132, respectively) and disturbance of consciousness. In the first week, the unfavorable outcome group (n = 11) had significantly higher diffusion-weighted imaging score than did the favorable outcome group (n = 8) (Mann-Whitney U test, P = .005). Multivariate logistic regression analysis showed that the diffusion-weighted imaging score (odds ratio, 18.182; 95% confidence interval: 1.36, 243.01; P = .028) was significantly associated with unfavorable outcome. In the 12th month, the fluid-attenuated inversion recovery score or diffusion-weighted imaging score ( P = .994, P = .997, respectively) were not significantly associated with unfavorable outcome. Patients with rhombencephalitis who have a higher diffusion-weighted imaging score are more likely to have an unfavorable 1-week clinical outcome.

scholarly journals Predictive Factors for Successful Treatment in Candidial Bone and Joint Infection

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S97-S98
Author(s):  
Wooyong Jeong ◽  
In Young Jung ◽  
Heun Choi ◽  
Jinnam Kim ◽  
Se Ju Lee ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Successful Treatment ◽  
Joint Infection ◽  
Case Series ◽  
Unfavorable Outcome ◽  
Neutrophil Lymphocyte Ratio ◽  
Bone And Joint Infection ◽  
Outcome Group ◽  
End Of Treatment ◽  
Significant Difference

Abstract Background Candidiasis is a major cause of morbidity and mortality, causing a diverse spectrum of clinical diseases. Candidial bone and joint infection (CBJI) is a rare clinical disease, although it is one associated with significant morbidity. As most prior studies were limited to individual cases and small case series, there were insufficient data on the epidemiology and outcome of CBJI. The aim of this study is to identify the predictive factors for successful treatment in CBJI. Methods A retrospective review was performed on 33 patients with Candida confirmed on culture, among patients diagnosed with bone and joint infection between January 2006 and December 2016 at a 2400-bed tertiary hospital in South Korea. Unfavorable outcome was defined as recurrence following completion of treatment or mortality. Clinical characteristics, treatment outcome, and medical records were reviewed. Results Of the 33 patients, 15 (45.5%) had unfavorable outcomes; recurrence (n = 9) and mortality (n = 6). Median age was 64.0 years (range, 50.5–71.5 years) and there were 14 (42.4%) males. Seventeen (51.5%) patients had arthritis and 16 (48.5%) osteomyelitis. Candida albicans constituted 48.5%, C. parapsilosis 24.2%, C. tropicalis 6.1%, and C. glabrata6.1%. Mechanisms of infection were hematogenous dissemination (57.6%) and direct inoculation (42.4%). There were no significant differences between the favorable outcome group and the unfavorable outcome group for the underlying diseases. The neutrophil percentage in complete blood count at the time of diagnosis showed a difference between the two groups (68.0% vs. 79.6%, P = 0.016). There was a significant difference in neutrophil-lymphocyte ratio (2.2 vs. 4.8, P = 0.023), erythrocyte sedimentation rate (ESR) (40.5 vs. 72.4, P = 0.024) and C-reactive protein (CRP) (15.3 vs. 86.3, P = 0.001) at the end of treatment. The duration of antifungal therapy showed a significant difference (124.9 days vs. 44.3 days, P = 0.041), but there was no difference in the operation. In the multivariate analysis, CRP at the end of treatment &#x2028;(P = 0.028) ws found to be a predictive factor for successful treatment. Conclusion CBJI is a rare disease but associated with high treatment failure. Prolonged antifungal treatment is essential for successful treatment of CBJI, and CRP at the end of treatment is a key predictive marker of successful treatment. Disclosures All authors: No reported disclosures.

scholarly journals Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 35 (8) ◽  
pp. 763-773 ◽  
Author(s):  
Petek Eylul Taneri ◽  
Sergio Alejandro Gómez-Ochoa ◽  
Erand Llanaj ◽  
Peter Francis Raguindin ◽  
Lyda Z. Rojas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Iron Metabolism ◽  
Binding Capacity ◽  
Ferritin Level ◽  
Meta Analysis ◽  
Older Age ◽  
Bibliographic Databases ◽  
Distribution Width ◽  
Significant Difference ◽  
The Impact

Abstract Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), − 4.08 g/L (95% CI − 5.12; − 3.05)] and red blood cell count [WMD, − 0.16 × 1012 /L (95% CI − 0.31; − 0.014)], and higher ferritin [WMD, − 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.

scholarly journals Hydroxocobalamin. I. Blood Levels and Urinary Excretion of Vitamin B12 in Man After a Single Parenteral Dose of Aqueous Hydroxocobalamin, Aqueous Cyanocobalamin and Cyanocobalamin Zinc-Tannate Complex

Blood ◽  
1961 ◽  
Vol 18 (5) ◽  
pp. 511-521 ◽  
Author(s):  
GEORGE B. JERZY GLASS ◽  
HELEN R. SKEGGS ◽  
DUK HO LEE ◽  
E. LINN JONES ◽  
WILLIAM W. HARDY
Keyword(s):  
Urinary Excretion ◽  
Vitamin B12 ◽  
Blood Level ◽  
Intramuscular Injection ◽  
Serum Vitamin ◽  
Blood Levels ◽  
Parenteral Dose ◽  
Single Intramuscular Injection

Abstract A single intramuscular injection of 500 or 1000 µg. of hydroxocobalamin to 17 individuals resulted in a 1.8- to 4.1-times higher mean serum vitamin B12 blood level, respectively, 5 hours after injection; a 4.6- and 12.8-times higher level 24 hours after injection; a 2.4- and 5.2-times higher level 72 hours after injection, and a 1.6- and 2.4-times higher level by the 2nd through the 4th week after injection than identical doses of cyanocobalamin administered to 19 individuals. The vitamin B12 blood levels following i.m. administration of 500 or 1000 µg. of hydroxocobalamin were significantly higher during the first 24 and 48 hours, respectively, than they were after a cyanocobalamin zinc-tannate complex given to 17 individuals at identical doses. After a single i.m. injection of 500 or 1000 µg. of hydroxocobalamin, an average of only 16 per cent and 27 per cent, respectively, of the vitamin B12 was lost in the 72-hour urines, as compared to 60 per cent and 69 per cent, respectively, after identical doses of cyanocobalamin. These differences, again, were highly significant statistically. The results of these studies give evidence of a slower rate of urinary excretion of hydroxocobalamin as compared to that of cyanocobalamin, and of its ability to build up consistently higher and more prolonged vitamin B12 levels in the blood.

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